Jennifer M Tibbetts, M.ED, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00010675 Issued in WA

Practice address

18209 Sr 410 E
Suite 304
Bonney Lake, WA 98391-5146

Phone

(253) 229-0322

NPI assigned

Aug 1, 2013

Last updated

Aug 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1043642978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18209 SR 410 E",
            "address_2": "SUITE 304",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983915146",
            "telephone_number": "253-229-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18209 SR 410 E",
            "address_2": "SUITE 304",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983915146",
            "telephone_number": "253-229-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.ED, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "00010675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tony Tong, PHARMD
• Duy Trinh, NP

• Mental Health Counselor in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.